摘要
目的比较莫西沙星与左氧氟沙星联合常规用药方案治疗耐多药肺结核的临床效果。方法选取2018年1—12月衡阳市第三人民医院收治的耐多药肺结核患者84例,按照收治先后顺序分为观察组和对照组,各42例。2组均接受常规抗结核分枝杆菌药物方案,在此基础上,对照组予以左氧氟沙星片治疗,观察组则予盐酸莫西沙星片治疗,2组均治疗12个月。比较2组治疗效果、痰菌转阴率、病灶吸收率、空洞闭合率,治疗前后炎性因子指标[肿瘤坏死因子-α(TNF-α)、白介素-4(IL-4)、白介素-6(IL-6)]、免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))变化及不良反应。结果观察组患者治疗总有效率为83.33%,高于对照组的54.76%(χ^(2)=8.021,P=0.005);观察组痰菌转阴率、病灶吸收率、空洞闭合率均高于对照组(P<0.05或P<0.01);治疗12个月后,2组TNF-α、IL-4、IL-6水平及CD8^(+)均较治疗前降低,CD4^(+)、CD4^(+)/CD8^(+)均较治疗前上升,且观察组降低/上升的程度大于对照组(P均<0.01);观察组不良反应总发生率为9.52%,低于对照组的30.95%(χ^(2)=5.974,P=0.015)。结论莫西沙星联合常规用药方案治疗耐多药肺结核的临床效果较左氧氟沙星更利于患者病情改善与免疫功能的提高,且安全性高,值得临床推广应用。
Objective To compare the clinical effects of moxifloxacin and levofloxacin combined with conventional regimen in the treatment of multi drug resistant pulmonary tuberculosis.Methods Eighty-four patients with MDR-TB treated in Hengyang Third People′s Hospital from January to December 2018 were divided into observation group and control group,with 42 cases in each group.Both groups received routine anti Mycobacterium tuberculosis drug regimen.On this basis,the control group was treated with levofloxacin tablets and the observation group was treated with moxifloxacin hydrochloride tablets.Both groups were treated for 12 months.The therapeutic effect,sputum negative conversion rate,focus absorption rate,cavity closure rate,the changes of inflammatory factor indexes(TNF-α,IL-4,IL-6)and immune function indexes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))before and after treatment,as well as the incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 83.33%,higher than 54.76%of the control group(χ^(2)=8.021,P=0.005).The sputum negative conversion rate,focus absorption rate and cavity closure rate in the observation group were higher than those in the control group(P<0.05 or P<0.01).After 12 months of treatment,the levels of TNF-α,IL-4,IL-6 and CD8^(+)in the two groups were lower than those before treatment,and the levels of CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group(P<0.01).The total incidence of adverse reactions in the observation group was 9.52%,lower than 30.95%in the control group(χ^(2)=5.974,P=0.015).Conclusion The clinical effect of moxifloxacin combined with conventional drug regimen in the treatment of multidrug-resistant pulmonary tuberculosis is more conducive to the improvement of patients′condition and immune function than levofloxacin,and has high safety,which is worthy of clinical application.
作者
周龙
赵峰
李双
ZHOU Long;ZHAO Feng;LI Shuang(Department of Drug Resistant Tuberculosis,Hengyang Third People′s Hospital,Hunan Province,Hengyang 421001,China)
出处
《临床合理用药杂志》
2022年第20期15-18,共4页
Chinese Journal of Clinical Rational Drug Use
关键词
耐多药肺结核
莫西沙星
左氧氟沙星
抗结核药物
临床效果
Multi drug resistant pulmonary tuberculosis
Moxifloxacin
Levofloxacin
Anti tuberculosis drugs
Clinical effect
